Giant Dedifferentiated Melanoma Mimicking Soft Tissue Sarcoma with Loss of Conventional Melanocytic Markers: Diagnostic Utility of PRAME and BRAF V600E Immunohistochemistry

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ID: 314200
2026
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Abstract
Dedifferentiated melanoma can lose conventional melanocytic markers and mimic soft tissue sarcoma, complicating diagnosis. In some cases, next-generation sequencing (NGS) has been required to secure the diagnosis. We report a giant (>10 cm) sarcomatoid melanoma in which diffuse PRAME immunohistochemistry raised suspicion and concordant BRAF V600E positivity in both the sarcomatoid tumor and an associated nevus established the diagnosis of melanoma. This two-step, widely accessible workflow, PRAME screening followed by targeted BRAF V600E testing, enabled diagnosis without comprehensive NGS and may aid similarly challenging sarcomatoid cutaneous tumors.
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Authors Moe Usui, Yasuaki Ikuno, Shingo Hirano, Yoshimichi Kobayashi, Takahiro Koike, Yasuhiro Maeda, Akihiko Yamaguchi, Toshifumi Takahashi, Akiko Arakawa, Mai Noujima, Noriki Fujimoto
Journal clinical and experimental dermatology
Year 2026
DOI
10.1093/ced/llag217
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